"While it is always upsetting when we cannot provide a transplant, we have an obligation to ensure that transplants are successful and that donor organs will remain viable," the statement said. "We thoughtfully review candidates for heart and lung transplant procedures with care and compassion, and these are often highly complex, difficult decisions. While our primary focus is the medical needs of the patient, the fact is that transplants require lifelong care and immunosuppression drugs, and therefore costs are sometimes a regrettable and unavoidable factor in the decision making process."